Individual
DR. IAN JAMES MIDDLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1559 FARMERS LN, SANTA ROSA, CA 95405-7525
(707) 571-2020
(707) 540-6299
Mailing address
1559 FARMERS LN, SANTA ROSA, CA 95405-7525
(707) 571-2020
(707) 540-6299
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5308T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0053080
—
CA
Enumeration date
06/10/2005
Last updated
07/22/2010
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